Providence Health & Services Mt

NPI #1790931517 in Missoula, Montana

Provider Information

NPI Number: 1790931517
Entity Type: Organization
Organization Name: Providence Health & Services Mt
Subpart: Yes (part of a larger organization)
Parent Organization: PROVIDENCE HEALTH & SERVICES
Primary Specialty: Family Medicine
Enumeration Date: Aug 12, 2008
Last Updated: May 7, 2025

Practice Location

Address: 3075 N RESERVE ST
Address 2: SUITE Q
City: Missoula
State: Montana
ZIP Code: 59808-1390
Phone: (406) 327-1850

Authorized Official

Name: MR. DONALD W ANDERSON JR.
Title: ASSISTANT SECRETARY ENROLLMENT
Phone: (425) 358-9786

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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